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Adat Shalom College Connections
Thank you for helping clergy and education staff stay connected to your undergraduate / graduate student.
Our database is updated each fall.
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STUDENT / YOUNG ADULT INFORMATION
Name
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Your answer
Mailing Address
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Your answer
City, State, and Zip
*
Your answer
Cell Phone
*
Your answer
Email Address
*
Your answer
College/Grad School/University
Your answer
Date of Birth
MM
/
DD
/
YYYY
Expected year of Graduation
MM
/
DD
/
YYYY
Parent(s) Name(s)
*
Your answer
Parent(s) email address
*
Your answer
Comments
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